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Lice are small parasites that live entirely on humans. Pediculosis is the term for an infestation of lice. The female lice hold on to skin or hairs and lay their eggs, called nits. Adult lice are the size of a sesame seed, have six legs, and are tan to greyish-white. Both the adults and the immature larvae feed on human blood. The small bites from the lice are intensely irritating which leads to scratching and potential for secondary skin infections from bacteria on the skin.

  • Body lice

  • Larger in size than head or pubic lice

  • Live in seams of clothing

  • Head lice

  • Live on scalp, eyebrows, eyelashes

  • Most common in children

  • Pubic lice

  • Live in pubic area, occasionally on other coarse hair such as armpits or beard


Mode of Transmission:

Direct contact


Examples of Transmission:

Lice can be transmitted by close direct contact with someone who has lice or with infected clothing, towels, or bedding. Lice crawl and cannot fly.

Prevention: Infestation with body lice is unlikely to last on anyone who bathes regularly and who has at least weekly access to freshly laundered clothing and bedding. Head lice are less easily removed and are NOT an indication of poor hygiene, as simple shampoos will not remove the adults or nits. Other preventive measures include:

  • Do not share personal items such as bedding, towels or combs

  • Launder community linens daily with hot water

  • Using Universal Precautions

    • Hand hygiene (wash with soap and water or using an alcohol based hand rub)

    • Proper handling and disposal of instruments/devices and contaminated clothing



Universal precautions.


Signs and Symptoms: The more common areas of the body where lice can be found are: along the scalp, the waistband, in the armpits, at the bra strap, or anywhere clothing is tighter and closer to the body. Intense itching is the main symptom others may include: 

  • Red bumps on skin

  • Areas where skin has been excessively scratched

  • Tiny white specks (eggs, or nits) on the bottom of hair shafts that are hard to remove

  • Itching may persist for 2 to 4 weeks after lice have been removed        



One complication results from the intense itching that leads to scratching of the skin. Once the skin is scratched, small cuts form and can become infected with bacteria. These parasites are also highly contagious and other family members need to be evaluated and treated as well.


Exposure Determination: 

A physician can diagnose the presence of lice through an exam of hair, skin and clothing.


General Post Exposure Treatment:

Improved hygiene and access to regular changes of clean clothes is the only treatment needed for body lice infestations. Head lice can be diagnosed at home by finding the nits or adults along the scalp. Treatment is recommended even if only one egg is found.


For Head Lice:

  • Use over-the-counter shampoos containing 1% permethrin; retreatment in 9 days to kill newly hatched eggs may be necessary

  • Prescription shampoos containing malathion 0.5% or benzyl alcohol are recommended if treatment with over-the-counter shampoos is not successful

  • Remove the nits (eggs)

    • Dishwashing detergent can help dissolve the ‘glue’ that helps nits stick

    • Nit combs are specially designed to remove the eggs

    • Repeat combing for nits in 7-10 days

  • Consult the OC Med clinic physician if the medications fail or for any signs of skin infection


For All Lice Infestations:

  • Destroy or carefully wash infected clothing, bedding and towels in hot water (at least 130⁰ F), then machine dry using a hot cycle.

  • Items that cannot be washed in hot water must either be destroyed or sealed (suffocated) in plastic bags and not used for 10 - 14 days.

  • Treat all potentially infected sources to eliminate reinfection.

  • Lice can live for varying periods off the human host:(Body: 5 - 10 days, Head: 2 days,  Pubic: 1 day)


Paperwork Required

  1. The City “Report of Employee Injury” form

  2. Medical Service Order- RM -67 (when medical care is required)

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